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DOH Posts Capital Webinar, Provides Updates on Payment Issues

In a meeting with LeadingAge NY and other associations on nursing home Medicaid issues, Department of Health (DOH) staff formally announced Ann Foster’s retirement and introduced Michael Spitz as her successor. Ann was the Deputy Director of the Division of Finance and Rate Setting and had lent her knowledge to various initiatives important to nursing home providers. Mike came to DOH in 2021 after a number of years working on health care issues at the Division of the Budget (DOB) and most recently has been working alongside the Director of the Bureau of Nursing Home and Long Term Care Reimbursement.

As the time of year approaches when DOH customarily issues a number of payment adjustments, the Department is still awaiting federal approval for a number of Medicaid State Plan Amendments (SPAs). The SPA that would authorize changes to the 2021 Nursing Home Quality Initiative (NHQI) still awaits action, as does the Upper Payment Limit submission that would allow Intergovernmental Transfer payments for public nursing homes to move forward. This makes it hard to predict when lump sum supplemental payments that are made concurrently with NHQI adjustments will be made. The Department is working on the 2021 cash receipts assessment reconciliation, and the July 2022 rates are now in executive review. However, there are no dates associated with either rate adjustment yet.

The Office of the Medicaid Inspector General (OMIG) is completing work on 2017 Minimum Data Set (MDS) audits. Asked about the health care worker bonus and the difficult position providers are in due to unanswered questions, the primary recommendation from the OMIG representative was that providers ensure that they maintain complete, contemporaneous documentation, especially from the time of the claim to the time that the employee receives the funding. As the Rate Setting Bureau has consistently done, they indicated that they were not the contact point for staffing level regulation or staffing funding questions.

DOH reminded participants that preview capital rate attestations are due Nov. 30th, but that earlier submissions were encouraged to help accelerate the process. The presentation and slides from the Nov. 3rd webinar are now posted on the DOH website here under the “Nursing Home Capital/Capital Attestations” selection.

Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841